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Repicci II® 单髁膝关节置换术:9 年的存活率和功能。

The Repicci II® unicondylar knee arthroplasty: 9-year survivorship and function.

机构信息

St Vincent's Clinic, Sydney, NSW, Australia.

出版信息

Clin Orthop Relat Res. 2010 Nov;468(11):3094-102. doi: 10.1007/s11999-010-1474-6. Epub 2010 Aug 13.

Abstract

BACKGROUND

Unicompartmental knee arthroplasty (UKA) is a recognized procedure for treatment of medial compartment osteoarthritis. UKA using minimally invasive surgery (MIS) has the theoretical advantage of less bone resection and quicker rehabilitation. Whether the function of patients with UKA compares with that of patients with conventional TKA is unclear.

QUESTIONS/PURPOSES: We determined (1) the length of stay and complications associated with a short-stay MIS protocol; (2) whether MIS techniques allow for accurate positioning of the implant and alignment of the limb; (3) the change in functional scores; (4) the revision rate, reasons for revision, and survival of this implant.

PATIENTS AND METHODS

We prospectively followed 100 patients who had 114 UKAs. All completed an International Knee Society (IKS) score preoperatively, at 1 year, and at last followup. We determined survivorship. Minimum followup was 5.2 years (mean, 7.4 years; range, 5.2-9 years).

RESULTS

Mean length of stay was 1.2 days, with 41% discharged the same day. The perioperative complication rate was 6%. The mean IKS score improved from 77 to 93 and was 86 at last followup. The mean hip-knee-ankle axis changed from 6° varus to 1.7° varus. Twenty-two patients underwent a revision procedure at a mean 6.2 years after the index procedure. Survivorship of the prosthesis was 78% at 9 years.

CONCLUSIONS

The short-stay protocol was not associated with a high perioperative complication rate. This technique is associated with improvement in function and restoration of limb alignment, allowing accurate positioning of the implant. Compared with other reports of survival of UKA, this implant had a lower survivorship and increased revision rate.

摘要

背景

单髁膝关节置换术(UKA)是治疗内侧间室骨关节炎的一种公认的手术方法。微创外科(MIS)的 UKA 具有骨切除量少和康复更快的理论优势。但是 UKA 患者的功能是否与常规 TKA 患者的功能相当尚不清楚。

问题/目的:我们旨在确定:(1)短期 MIS 方案相关的住院时间和并发症;(2)MIS 技术是否可以实现植入物的准确定位和肢体的对线;(3)功能评分的变化;(4)该植入物的翻修率、翻修原因和生存率。

患者和方法

我们前瞻性随访了 100 例 114 例 UKA 患者。所有患者在术前、1 年和最后随访时均完成了国际膝关节协会(IKS)评分。我们确定了生存率。最低随访时间为 5.2 年(平均 7.4 年;范围,5.2-9 年)。

结果

平均住院时间为 1.2 天,41%的患者当天出院。围手术期并发症发生率为 6%。IKS 评分平均从 77 分提高到 93 分,最后随访时为 86 分。平均髋膝踝轴从 6° 变为 1.7°。22 例患者在索引手术后平均 6.2 年接受了翻修手术。假体的 9 年生存率为 78%。

结论

短期方案并未导致围手术期并发症发生率升高。该技术可改善功能并恢复肢体对线,实现植入物的准确定位。与 UKA 生存率的其他报告相比,该植入物的生存率较低,翻修率较高。

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